University of Iowa Department of Radiology, Section of Pediatric Radiology
Peer Review Status: Internally Peer Reviewed
First Published: 2002
Last Revised: 2005
A delayed cystogram or VCUG (voiding cystourethrogram) is an X-ray examination of the bladder and urethra. After a plain film (without X-ray contrast) is obtained, the child's genital area is scrubbed and prepared with sterile materials. This may feel cold because of the soap used. The child is then catheterized using a small tube that goes directly into the bladder. This may cause discomfort in some children. The tube in the bladder is then connected to a bottle of X-ray contrast that is dripped by gravity until the bladder is filled. The bladder is observed intermittently under fluoroscopy to see if any reflux occurs (when contrast goes backward up one or both ureters).
After the bladder is filled, a series of films are obtained showing the configuration of the bladder and urethra upon voiding. A final radiograph is taken after the child has voided completely, to see how well the bladder empties.